Decreased conversion of androgens to normal 17-ketosteroid metabolites: A nonspecific consequence of illness

Barnett Zumoff, H. Leon Bradlow, T. F. Gallagher, Leon Hellman

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

In order to study the nonspecific influence of illness on the peripheral metabolism of androgens, trace amounts of 14C-testosterone were administered intravenously to 16 healthy control subjects (4 men and 4 women aged 23-35, and 5 men and 3 women aged 68-86) and to 47 patients (26 men and 21 women, aged 16-84) with a wide variety of types and severity of illness, and trace amounts of 14C-dehydroisoandrosterone were administered to 13 healthy controls (3 men and 4 women aged 21-32, and 3 men and 3 women aged 67-85) and to 15 patients (9 men and 6 women, aged 19-82) with various illnesses. It was found that both precursor hormones were converted to abnormally low proportions of androsterone and etiocholanolone in a large number of the patients, regardless of diagnosis. Mean recovery of etiocholanolone plus androsterone from 14C-testosterone in control subjects was 48% of the dose, with a coefficient of variation of 9%. Recovery in the ill patients was very variable, ranging from high normal to less than 1/3 of the normal mean. Thirty of the 47 patients had recoveries below the lowest normal value. For the patient group as a whole, the mean recovery was 34% of the dose, with a coefficient of variation of 32%. From 14C-dehydroisoandrosterone mean recovery in control subjects was 36%. Mean recovery in the patient group was 26%, and 8 of the 15 patients had recoveries below the lowest normal value. The decreased recovery of androsterone and etiocholanolone appears to represent actual decrease in the formation of these metabolites, with equivalent increase in the formation of polar metabolites, largely uncharacterized. Decreased excretion of metabolites into the urine appears to play only a minor role, and formation of abnormal conjugates plays no role at all. The magnitude of the observed decrease in conversion of androgen precursors to androsterone and etiocholanolone is quite sufficient to account for the reported findings of low endogenous urinary 17-ketosteroids (or specific metabolites) in ill patients, without postulating decreased secretion of androgen precursors. Since the postulate is unnecessary, and since no direct evidence exists to support it, it should be abandoned.

Original languageEnglish
Pages (from-to)824-832
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume32
Issue number6
DOIs
StatePublished - 1971
Externally publishedYes

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